CM insurance

No, you do not have to report your admission to CM's insurance companies in advance.

From 1 January 2025, a consultation for psychological support with a clinical psychologist or educational psychologist with an FOD visa number will be partially reimbursed. This is on condition that it falls within a period of pre- and aftercare or if it is directly related to a recognised serious illness. A maximum of 40 euros per session will be reimbursed, after any reimbursement from the additional CM services and benefits. A maximum of 200 euros will be reimbursed per insured person and per calendar year.

You can find more information about this in the general terms and conditions.

CM-Hospitaalplan provides for a reimbursement of max. 2 euros per hour worked (max. 30 hours worked) per delivery for maternity care services provided from calendar year 2025.
This within the period of 2 months before the (expected) date of delivery until 4 months after the date of birth in case of a home birth or outpatient delivery. Or until 4 months after the child is discharged from the hospital in case of a hospital delivery.

Even better insured? CM-Hospitaalplan Plus provides a reimbursement of max. 6 euros per hour per hour worked (max. 30 hours worked) per delivery.
This within the period of 2 months before the (expected) date of delivery until 6 months after the date of birth in case of a home birth or outpatient delivery. Or until 6 months after the child is discharged from the hospital in case of a hospital delivery.

No, those who are affiliated with CM-Hospitaalplan or CM-Hospitaalplan Plus will not receive a card for this. So you do not need to bring anything, give anything or mention anything in the hospital.

You can freely choose your hospital, unless you are transported by 112 in an emergency.

If your doctor is affiliated with a hospital, your freedom of choice is also limited. In principle, your doctor contacts the hospital to record the admission and make the necessary medical arrangements (e.g. reservation of an operating room).

You can compare hospital rates with the ' Compare Hospital Rates ' application.

A hospital is an institution that is legally recognized and that uses scientifically proven diagnostic and therapeutic resources.

The following institutions, among others, are not considered hospitals:

• medical-pedagogical institutions
• rest and nursing homes, nursing homes for the elderly and hospitals and parts of hospitals that have special recognition as RVT
• thermal cure settings
• rehabilitation centers
• sanatoriums and preventoria
• psychiatric nursing homes
• private practices not recognized as a general hospital

You make a number of choices on the admission statement that have an important influence on the final cost. The document is not specifications, the hospital cannot predict all costs in advance. But it is binding. So read the admission statement thoroughly before signing it and keep your copy carefully.

CM-Hospitaalplan and CM-Hospitaalplan Plus reimburse the costs of unplanned/unexpected hospital admissions outside Belgium up to 1,000 euros per calendar year and per insured. As a CM member, you also enjoy travel assistance abroad.

For planned hospitalisations outside Belgian territory, you require prior permission from the CM advisory physician.

In principle, your doctor decides on the duration of your stay. But as a patient you have the right to leave the hospital whenever you want.

If this happens against the doctor's advice, you must sign a document stating that you are leaving at your own risk. The doctor then declines all responsibility for the consequences of your departure.

Yes, the hospital may request an advance. The amount depends on your room type and is stated on the admission statement. After seven days, the hospital can ask you for a new advance. The amount may be higher if you do not have health insurance in order.

A hospital may not refuse you admission (in a communal room), even if you cannot pay the advance.

You can find the glossary here .

At CM-Hospitaalplan, the maximum reimbursement is 22,000 euros per member per calendar year for both hospital admissions and pre- and post-treatment. For admissions from 1 January 2025, this amount will be increased to 25,000 euros.

Even better insured? With CM-Hospitaalplan Plus, the maximum reimbursement per member per calendar year is 40,000 euros for both hospital admissions and pre- and post-treatment.

For outpatient costs for serious illnesses, the maximum reimbursement is 7,000 euros from CM Hospital Plan or CM Hospital Plan Plus.

The reimbursement for admission to a psychiatric hospital is always limited to 1,250 euros (for admissions from 1 January 2025: 1,500 euros) per insured person and per calendar year under the CM-Hospitaalplan.

Even better insured? CM-Hospitaalplan Plus provides reimbursement for admission to a psychiatric hospital up to 2,000 euros per insured person and per calendar year.

For admissions to a psychiatric department of a general hospital (PAAZ), the ceiling amounts mentioned above do not apply. Admission and the costs of pre- and post-hospitalization care are reimbursed within the 'hospitalization guarantee' and the 'pre- and post-hospitalization guarantee':

• child neuropsychiatry (K, service code 340);
• day care in a K-shift (K1, shift code 350);
• night care in a K-shift (K2, shift code 360);
• neuropsychiatry service (A, service code 370);
• day care in an A-shift (A1, shift code 380);
• night care in an A-shift (A2, shift code 390);
• psychiatric service (T, service code 410);
• day care in a T-shift (T1, shift code 420);
• night care in a T-shift (T2, shift code 430);
• intensive treatment service for psychiatric patients (IB, service code 480);
• psychogeriatric disorders service (S6, service code 660).

Half of the daily rate for your recovery stay in Ter Duinen (Nieuwpoort), Hooidonk (Zandhoven) and Nivezé (Spa) is reimbursed for a maximum of thirty days per calendar year. Always provide CM with proof of these costs, together with this completed form .

Since January 1, 2023, costs for reception and care in a short stay are reimbursed at 50% of the amount actually paid, with a maximum of 15 euros per day of short stay with overnight stay, for a maximum of 28 short stay days with overnight stay per calendar year.

Have you received your hospital bill? Take it to hand and start filing. You do not need a scanner or camera for this, the filing is done based on the invoice number.

Here you will find a video that shows you step by step how it works. After the declaration you will receive a payment overview and the refund on your account number.

Are you unable to submit your declaration digitally? Then print the declaration form , fill it in and submit it signed together with your hospital invoice by e-mail or via a CM mailbox .

For the costs below, the refund will not be automatic. Always provide CM with proof of these costs, together with this completed form.

• invoices for urgent patient transport (112 transport)
• invoices from the recognized rehabilitation centers Ter Duinen in Nieuwpoort, Hooidonk in Zandhoven and Domaine de Nivezé in Spa
• remaining medical costs after reimbursement by another hospital insurance

Unless otherwise stated, CM-Hospitaalplan and CM-Hospitaalplan Plus will automatically reimburse the majority of your medical costs that are directly related to your hospital. You do not need to take any action yourself. For CM-Hospitaalplan, this concerns medical costs in the period from 1 month before to 3 months after your admission. For admissions from 1 January 2025, this period will be extended to 2 months before to 4 months after your admission. Please note: does not apply to all day admissions.

Even better insured? CM-Hospitaalplan Plus reimburses up to 100% of medical costs 2 months before and up to 6 months after your admission for examinations, check-ups, aftercare and rehabilitation.

All excess and reimbursable supplements such as GP visits, medicines, follow-up appointments at the hospital or specialist's practice, laboratory costs, etc. are automatically reimbursed. So you don't have to do anything yourself. You must of course still submit doctor's certificates via the CM letterbox.

CM Insurance automatically processes all these related costs at the following times:

• 4 months after your discharge from the hospital
• 7 months after your discharge from hospital
• 10 months after your discharge from hospital (for admissions from 1 January 2025)

For the following costs, the refund is not automatic. Always provide CM with proof of these costs, together with this completed form :

• invoices for urgent patient transport (112 transport)
• invoices from the recognized rehabilitation centers Ter Duinen in Nieuwpoort, Hooidonk in Zandhoven and Domaine de Nivezé in Spa
• remaining medical costs after reimbursement by another hospital insurance.

You will receive a refund of the costs of your admission (according to the hospitalization guarantee). You will not receive a refund of costs during the pre- and post-treatment.

You will receive a refund of the costs of your admission (according to the hospitalization guarantee). You will not receive a refund of costs during the pre- and post-treatment.

• The excess and the lump sum for your medicines will be fully reimbursed, regardless of your choice of room.
• The room supplement for your single room is reimbursed from CM-Hospitaalplan up to 55 euros per day. For admissions from 1 January 2025 you will receive a refund up to 65 euros per day.
• Even better insured? CM-Hospitaalplan Plus provides a refund of up to 95 euros per day for the room supplement for your single room.

• The costs for an overnight stay of one person in a member's hospital room are reimbursed up to 35 euros per day from CM-Hospitaalplan. For admissions from 1 January 2025, you will receive a reimbursement of up to 40 euros per day including meals.
• Even better insured? CM-Hospitaalplan Plus provides reimbursement of the costs for an overnight stay of one person in a member's hospital room up to 60 euros per day, including meals.
• The accommodation costs associated with the donation that are medically required for the treatment of the member will be fully reimbursed

• Fertility treatments
  Reimbursement is possible for both the (day) admission and pre- and post-treatment. The total reimbursement is limited to 1000 euros per insured, regardless of the number of fertility treatments. From 1 January 2025, the ceiling amount will be increased to 1,500 per insured.
   
• Breast reductions
  During the first three years of your affiliation with CM-Hospitaalplan or CM-Hospitaalplan Plus, the costs are reimbursed as a pre-existing condition. Afterwards, they are reimbursed according to the reimbursements for hospitalization and pre- and post-treatment. Are you coming over continuously from a similar mutual insurance? Then that period can possibly be reduced.
  The total reimbursement from CM-Hospitaalplan is always limited to 1000 euros per insured. From 1 January 2025, the ceiling amount will be increased to 1,500 per insured. Even better insured? The total reimbursement from CM-Hospitaalplan Plus for breast reductions amounts to 2,000 euros per insured.
   
• Procedures to treat obesity (e.g. liposuction, gastric banding, etc.)
  During the first three years of your affiliation with CM-Hospitaalplan or CM-Hospitaalplan Plus, the costs are reimbursed as a pre-existing condition. Afterwards, they are reimbursed according to the reimbursements for hospitalization and pre- and post-treatment. The total reimbursement from CM-Hospitaalplan is always limited to 1000 euros per insured person. From 1 January 2025, the ceiling amount will be increased to 1,500 per insured person. Even better insured? The total reimbursement from CM-Hospitaalplan Plus for interventions to treat obesity is 2,000 euros per insured person.

CM-Hospitaalplan reimburses the costs below that are directly related to your home birth and that occur from 1 month before the birth and up to 3 months afterwards. For home births from 1 January 2025, this period will be extended to 2 months before the birth and up to 4 months afterwards.

• maternity care
• co-payment for medical care and treatment;
• fee supplements (up to 100% of the rate set by the INAMI);
• reimbursable medicines.

A lump sum of 100 euros is awarded for the costs of medical-technical aids.

Even better insured? CM-Hospitaalplan Plus reimburses the costs directly related to your home birth within the period from 2 months before the birth to 6 months afterwards.

If you want to limit your hospital bill for breast reconstruction, choose a hospital that has signed an agreement with the Riziv .

In these hospitals expensive (aesthetic) supplements are prohibited for breast reconstruction with own tissue in a double room. In a single room the charging of supplements is limited.

These supplements are reimbursed from CM-Hospitaalplan and CM-Hospitaalplan Plus in accordance with the provisions of the general terms and conditions.

• Medicines – for which there is also a reimbursement from the compulsory health insurance – are fully reimbursed from CM-Hospitaalplan from 1 month before and up to 3 months after the hospitalization. From 1 January 2025, this period will be extended to from 2 months before and up to 4 months after the hospitalization.
• Even better insured? CM-Hospitaalplan Plus provides the same reimbursement for this but within the period from 2 months before to 6 months after your admission.
• Non-reimbursable medicines are not reimbursed by CM-Hospitaalplan and CM-Hospitaalplan Plus in the pre- and aftercare period.

Plaster material – for which there is also reimbursement from the compulsory health insurance – is fully reimbursed.

The first reimbursable prosthesis or the first reimbursable orthopedic device prescribed by a doctor will be fully reimbursed.

From CM-Hospitaalplan, the first prosthesis or orthopedic device is also reimbursed up to 3 months after hospitalization if not placed during the hospitalization itself. For admissions from 1 January 2025, this period is extended to 4 months after hospitalization.

Even better insured? For CM-Hospitaalplan Plus this period is up to 6 months after your admission.

• Implants – for which there is also a reimbursement from the compulsory health insurance – are fully reimbursed from 1 month before to 3 months after the hospital admission from CM Hospital Plan. For admissions from 1 January 2025, this period is extended to 2 months before to 4 months after the hospital admission.
• Non-reimbursable implants and parapharmaceutical products (e.g. support stockings, neck braces) are fully reimbursed by CM Hospital Plan up to 2,500 euros per hospitalisation if they may be charged by law and this for the period from 1 month before to 3 months after the hospital admission. For admissions from 1 January 2025, this period is extended to 2 months before to 4 months after the hospital admission.
• Even better insured? CM-Hospitaalplan Plus provides the same reimbursement for these costs but within the period from 2 months before to 6 months after your admission.

Only the costs related to your (day) admission for dental care and the removal of wisdom teeth are reimbursed. The costs during the pre- and post-treatment are not included.

In the event of hospitalisation due to a serious illness or accident requiring dental care, pre- and post-care will also be reimbursed.

With a few exceptions, there is no reimbursement for dental prostheses and implants.

CM-Hospitaalplan reimburses supplementary fees up to 100% of the fixed rate, regardless of the room choice. Supplementary fees from 1 month before hospitalization and up to 3 months after hospitalization are also reimbursed up to 100% of the fixed rate.

Changes to the CM-Hospitaalplan from 1 January 2025: Supplementary fees will be reimbursed up to 150% of the fixed rate, regardless of the room choice. For day admissions, they will also be reimbursed up to 100% of the statutory rate from 1 January 2025. Supplementary fees in the period from 2 months before hospital admission to 4 months after hospital admission will be reimbursed up to 100% of the fixed rate.

Even better insured? With CM-Hospitaalplan Plus, additional fees are reimbursed up to 200% of the fixed rate, regardless of the room choice. For day admissions, they will also be reimbursed up to 100% of the statutory rate from 1 January 2025.

The deductible, which only applies to the reimbursement of additional fees for admission to a single room, is:

• 0 euros in case of hospital admission for childbirth;
• 100 euros per hospital admission for a classic admission with overnight stay;
• 175 euros per hospital admission for a day admission.

Even better insured? With CM-Hospitaalplan Plus, the 100 euro deductible is only applied if the additional fees at the time of admission are higher than 150%.

These deductibles are applicable per hospital admission with a maximum of 350 euros per calendar year.

Fees for services that may legally be charged but which are not reimbursed by the statutory health insurance will be reimbursed up to 200 euros per hospital stay if they do not fall under the exclusions of the insurance.

• malignant tumors (e.g. cancer);
• malignant blood diseases (e.g. leukemia, Hodgkin's disease);
• neuromuscular disorders such as ALS (amyotrophic lateral sclerosis;
• MS (multiple sclerosis)
• Parkinson's disease;
• meningitis;
• AIDS;
• cirrhosis of the liver due to hepatitis;
• diabetes type 1;
• kidney disease requiring kidney dialysis;
• cystic fibrosis;
• systemic sclerosis with organ involvement;
• Crohn's disease and ulcerative colitis.

Yes, additional fees are reimbursed up to 100% of the fixed rate by the RIZIV when serious illness is recognised. The co-payment for medical care and treatment is also fully reimbursed in these cases.

Medicines, implants, synthesis materials, plaster materials, stoma and incontinence materials are fully reimbursed if the health insurance also reimburses these.

The rental of medically necessary equipment is fully reimbursed in those cases. Always provide CM with proof of these costs, together with this completed form .

1. Deliver CM

• this form signed by yourself and your GP/specialist
• a recent medical report from your specialist, your GP can retrieve this from your medical file

Documents can be delivered to CM via [email protected] or via a CM mailbox . If necessary, you will have to apply for an extension of this recognition after some time. CM will provide you with the appropriate form for this in due time.

2. You will receive your refund

Once your application is approved, you will automatically receive reimbursement for outpatient expenses directly related to your condition. These may include GP visits, medications, follow-up appointments at the hospital or specialist’s office, lab costs and more.

You will receive the refund every 3 or 12 months.

3. You must enter other costs manually

Costs that cannot be processed automatically must be submitted manually via [email protected] or via a CM mailbox .

To do this, you complete the form 'application for non-automatic reimbursement for outpatient costs' .

You add proof of the costs incurred:

• invoices from recognized rehabilitation centers Ter Duinen in Nieuwpoort, Hooidonk in Zandhoven and Domaine de Nivezé in Spa
• invoices for the rental of medical equipment
• invoices for urgent patient transport (112 transport)

For the costs below, reimbursement does not occur automatically. Always provide proof of these costs, together with this completed form. Doctor's certificates, costs of maternity care and psychological care must of course still be submitted via the CM mailbox.

• invoices for urgent patient transport (112 transport)
• invoices from the recognized rehabilitation centers Ter Duinen in Nieuwpoort, Hooidonk in Zandhoven and Domaine de Nivezé in Spa
• remaining medical costs after reimbursement by another hospital insurance

• Costs for the services below and their consequences and complications:
  • (purely) aesthetic care or treatment, rejuvenation treatments or care with an aesthetic purpose;
  • preventive investigations;
  • spa treatments (e.g. thermalism, thalassotherapy, hygienic diet);
  • breast enlargements;
  • treatments and medicines whose benefits have not been scientifically proven;
  • dental prostheses and dental implants;
  • services that are not necessary for the restoration of health;
  • costs arising from the practice of dangerous sports and any sport as a professional activity, including training;
  • costs for deliberate medical treatment abroad without the permission of the medical advisor.
• Costs resulting from:
  • wars or disasters;
  • unrest, riots, collective violence;
  • intentional or reckless acts, bets or challenges;
  • crime;
  • drunkenness or alcohol intoxication, use of narcotics;
  • facts caused by radioactive, toxic or explosive substances.
• Costs that may not legally be charged.

We speak of a medical accident when you experience abnormal damage during medical treatment, a hospital admission or a medical examination. You can receive compensation for this. If you have a complaint about a medical accident, you can contact the Assistance to CM members service .

The statutory excess for urgent patient transport (112) is reimbursed up to 250 euros per calendar year from CM-Hospitaalplan and up to 300 euros per calendar year from CM-Hospitaalplan Plus. The condition is that the transport is followed by a hospital admission guaranteed by CM-Hospitaalplan or CM-Hospitaalplan Plus. Always provide CM with proof of these costs, together with this completed form .

For non-urgent patient transport, there is a CM reimbursement from the CM services and benefits package .

The personal contribution for consultation transport requested from the Mutas service in the context of an admission, discharge or consultation to or from a RIZIV-recognised hospital will be reimbursed up to a maximum of 250 euros per calendar year.

Even better insured? CM-Hospitaalplan Plus provides a reimbursement for the personal contribution for consultation transport requested from the Mutas service in the context of an admission, discharge or consultation from or to a RIZIV-recognised hospital up to a maximum of 300 euros per calendar year.

The personal share for series transport requested from the Mutas service in the context of oncological treatment or kidney dialysis is reimbursed up to a maximum of 250 euros per calendar year. You do not need to submit invoices for this yourself, the reimbursement is automatic. You do need a recognition of serious illness to be able to receive this reimbursement.

Even better insured? CM-Hospitaalplan Plus provides compensation for the personal share for series transport requested from the Mutas service in the context of oncological treatment or kidney dialysis up to a maximum of 300 euros per calendar year.

The choice of room plays an important factor in the cost of your hospitalisation:

• In a double or multi-person room, no room supplements or additional fees may be charged.
• In a single room, room and fee supplements are permitted.

If you do choose a single room, the reimbursement from CM-Hospitaalplan and CM-Hospitaalplan Plus is limited. For CM-Hospitaalplan:

• Room supplements are reimbursed up to 55 euros per day. For admissions from 1 January 2025, they are reimbursed up to 65 euros per day.
• Fee supplements are reimbursed up to 100% of the statutory rate set by the RIZIV. For admissions from 1 January 2025, they are reimbursed up to 150% of the statutory rate. For day admissions, they are reimbursed up to 100% of the statutory rate, also from 1 January 2025. These supplements can be high in some hospitals. It is best to ask the hospital about this in advance.
• In addition, a deductible is applied for a stay in a single room. The deductible is 175 euros for a day hospitalization and 100 euros for a hospitalization with an overnight stay. In the case of childbirth, no deductible is applied.

Even better insured? With CM-Hospitaalplan Plus, room supplements are reimbursed up to 95 euros per day and the additional fees are reimbursed up to 200% of the statutory rate. For day admissions, they will also be reimbursed up to 100% of the statutory rate from 1 January 2025. The deductible of 100 euros only applies if the additional fees are higher than 150% during your admission.

Important: during the first three years of affiliation, there is no reimbursement of room and fee supplements for a single room for hospitalizations due to a pre-existing condition or illness. The admission is reimbursed as for hospitalization in a double or multi-person room. In the case of pregnancy, this applies for the first nine months of affiliation.

• CM Insurance Terms of Use
• General terms and conditions 2023
• General terms and conditions 2024
• Information document CM Hospital Plan